Football & Cheerleading Coaching Application
PLEASE PRINT:
First Name: ________________ Last Name: ___________________________
E-mail: ________________________
Home Phone: (____) ______________Cell Phone: (____) _________________
Work Phone: (____) ________________
Address: ___________________________________
City, State, Zip: ________________________________________
Position applying for: Head Coach_____ Assistant Coach____ Student Coach______
Squad you would like to coach,
1st choice_______________________
2nd choice__________________________
Will you coach a squad other than the one your child is on _____________
Football/Cheerleading Experience:____________________________________________ Football/Cheerleading Coaching Training/Clinics:___________________________________________________
Any Other Relevant Skills or Training: ______________________________________________________________
List 3 goals you have for your squad if chosen
1) ________________________________________
2) __________________________________________
3) __________________________________________
References (church, organizations, other volunteer work):
1) _________________________________________
2) __________________________________________
3) _________________________________________
I certify that all information provided is correct and
accurate to the best of my knowledge and I give my permission to investigate any
information included in this application. I also grant my permission to
contact my references listed above. I assume all risk and hazards
incidental to such participation including transportation, and do hereby waive
and otherwise hold harmless the Pleasant Valley Cubs Association, their
officials, sponsors, coaches, and other participants. I agree to sign and
follow the Code of Conduct set forth by the Pleasant Valley Cubs. I also
agree to adhere to all the rules and regulation set forth by the
_______________________________________ ____________
Signature of Applicant Date